why_brachytherapy

Advantages

The rise in the number of men diagnosed with prostate cancer has led to a growing need for improved treatment options that can offer excellent cure rates with minimal side effects at a low cost. Brachytherapy has numerous advantages over other treatment options.

Cure rates:

Cure rates in low risk patients are equal to or better than surgery or external beam radiation. For intermediate and high-risk patients, brachytherapy combined with EBRT has resulted in superior outcomes when compared to surgery.1, 2

Minimally invasive:

With the seed implant, there are no incisions or stitches required such as in the case of surgery. Furthermore, there is minimal, if any, post-operative pain.3

Urinary Function:

When looking at urinary side effects, incontinence rates are usually less than 1%4. For surgery, rates can be as high as 10%5.

Sexual Function:

Approximately 6-25% of patients who receive brachytherapy will experience a decrease in sexual function6 versus approximately 50% of patients who undergo surgery7. Erectile medications and other aids have proven to be very effective.

Bowel Function:

When compared to EBRT, patients undergoing prostate brachytherapy experience much lower rates of bowel irritation with prostate brachytherapy8.

Convenience:

Since brachytherapy is an outpatient procedure, no hospital stay is required. Furthermore, the seed implant is complete in one visit whereas a number of months are required to complete a course of external beam radiation. Patients are not required to take weeks off of work such as in surgery. As we see younger and younger patients with full-time jobs, it is important that they do not interrupt their work schedule for a prolonged period of time. Patients are able to resume normal activity within a day.

Blood loss:

Blood loss during an implant is minimal when compared to surgery9.

Cost:

When compared to prostatectomy (surgical removal) or many weeks of external beam radiation, prostate brachytherapy is the most cost-effective treatment10.

References:

  1. Klein, E. Cleveland Clinic Localized Prostate Cancer Registry. In low-risk prostate cancer, quality of life is key to treatment choice. Urology Times, August 1, 2008.
  2. Bittner, N et al. Interstitial brachytherapy should be standard of care for treatment of high-risk prostate cancer. Oncology. August 2008, p. 995-1017.
  3. Moran BJ, Gurel MH, Visockis J, Geary P. Post-operative pain and prostate brachytherapy. Int J Radiat Oncol Biol Phys 2003; 54: Issue 2 Supplement 0.
  4. Feigenberg SJ, Lee WR, Desilvio ML, et alL Health-related quality of life in men receiving prostate brachytherapy on RTOG 98-05. Int J Radiat Oncol Biol Phys. 2005 Jul 15;62(4):956-64.
  5. Steineck G, Helgesen F, Adolfsson J, et al: Quality of life after radical prostatectomy or watchful waiting. N Engl J Med. 2002 Sep 12;347(11):790-6.
  6. Robinson JW, Moritz S, Fung T. Meta-analysis of rates of erectile function after treatment of localized prostate carcinoma. Int J Radiat Oncol Biol Phys. 2002 Nov 15;54(4):1063-8.
  7. Frank, SJ et al. An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer. J Urol. 2007 Jun;177(6) 2151-6.
  8. Zelefsky MJ, Fuks Z, Hunt M, et al: High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys. 2002 Aug 1;53(5):1111-6.
  9. Rassweiler J, Hruza M, Teber D, et al: Laparoscopic and robotic assisted radical prostatectomy--critical analysis of the results. Eur Urol. 2006 Apr;49(4):612-24
  10. Quang et al. Technologic evolution in the treatment of prostate cancer. Oncology (21) 13. 1598-1603.


  11. Seed implant | Prostate seed implant | Brachytherapy procedure | Prostate Biopsy | prostate cancer seeds